NPI 1518587120 · live from the CMS NPI Registry
Amanda Joy Dominik, CNP
Nurse Practitioner, Pediatrics in Arden Hills, MN. National Provider Identifier 1518587120, active.
NPI record
| NPI | 1518587120 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 4411 Arden View Ct, Arden Hills, MN 55112 |
| Practice phone | 651-331-0827 |
| Enumerated | April 23, 2020 |
| Last updated | April 23, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 7377 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.